It was projected that in 1994 there would be about 182,000 newly diagnosed breast cancer patients in the United States alone. It was estimated that between 4 to 10 percent of those patients needed biopsies to establish these diagnoses. Although the complication rate is about 5-10 percent, this still represents a sizeable number and thus must be addressed.
Complications arising from breast biopsies include infections, pain, ecchymoses and hematomas. Infection and pain can be effectively prevented or treated with medication. Ecchymosis and a hematoma, however, are not as effectively treated by medication.
During a biopsy, an incision is made in or around the breast. The targeted tissue is then partially or entirely removed for examination. During the removal process, a cavity is formed where the tissue was removed, and blood vessels may be incised that will cause internal bleeding (ecchymosis), possibly filling the cavity (hematoma).
A serious problem caused by ecchymosis or a hematoma is that malignant cells can be disseminated along the planes where ecchymosis or a hematoma exists, thus decreasing the probability of local control. This is in addition to the pain, tenderness and skin discoloration caused by these complications that detract from a patient's sense of well-being.
It has been reported that breast support is necessary during the immediate post-operative period to help prevent ecchymosis and hematoma. Also, compression has been used to reducing scarring from severe burns. Thus, compression could minimize scarring of the biopsy site. To this end, an ace bandage has been tightly wrapped around the chest to compress a post-operative breast. The compression closes the cavity and compresses the incised blood vessel to prevent and eventually terminate bleeding.
To apply the ace bandage wrap, the patient's torso must be positioned for facilitated circumnavigation of the chest, typically in a somewhat upright position. But the design of the ace bandage lends itself to awkward application, which is further exacerbated when the patient has been subjected to general anesthesia. Also, the ace bandage is hot, uncomfortable and is not easy to adjust its compression or fit once on the patient.
A surgical chest dressing is disclosed in U.S. Pat. No. 5,152,741 to Farnio entitled "SURGICAL CHEST DRESSING." It is formed from a chest encircling band of stretchable material with free ends that engage each other between the breasts. The band is constructed so as to provide more support along the sides of the user's body as compared with the support generally provided for the breasts and the back of the patient.
The dressing disclosed in the Farnio patent is not suitable for effective hematoma or ecchymosis prevention. The Farnio patent discloses that the dressing will conform to the body upon application and exert very little force on the patient. Specifically, front flaps of the disclosed dressing are made of a material that conforms to the shape that it overlays without exerting substantial pressure. The Farnio patent further discloses the desirability of material that will stretch out and accommodate different sized breasts. Thus, the dressing disclosed in the Farnio Patent is less effective at preventing a hematoma or ecchymosis than the ace bandage since its material conforms to, but does not exert a pronounced pressure on the breast.
U.S. Pat. No. 4,781,651 to Ekins entitled "ATHLETIC SUPPORT BRASSIERE" discloses a brassiere for energetic activities including an encircling band that has stretchable and elastic portions. Attached to the band are two cups that include relatively inelastic, non-stretchable material. A stabilizer strip is located directly beneath the encircling band to support the breasts by preventing their downward sag.
The brassiere disclosed in the Ekins patent also does not provide the requisite compression to effectively prevent a hematoma or ecchymosis. First, by the very nature of the cups of the disclosed brassiere, the breast is not compressed, but is shaped. Second, the material used for the cups is relatively inelastic and non-stretchable which also does not effectively compress the breast. Finally, the stabilizing strip simply prevents the breast from downward sag. This in no way compresses the breast to prevent a hematoma or ecchymosis.
Another chest dressing is disclosed in U.S. Pat. No. 5,098,331 to Corrado entitled "THERAPEUTIC CHEST DRESSING FOR BREASTS HAVING IMPLANTS." The dressing disclosed includes a chest encircling, flexible band provided with front flaps that engage each other while overlaying the breasts. A chest encircling strip is attached to the flexible band for preventing movement or distortion of the breast implants received in the flexible band.
The dressing disclosed in the patent to Corrado will not provide effective prevention of a hematoma or ecchymosis for many reasons. Most importantly, the Corrado dressing is designed not to compress the breast since that would be detrimental to the implant's shape and location in the chest. Specifically, most breast implants are located between the pectoralis major and minor muscles. Some body movement will cause the implants to rise between these muscles, which is not desired. Compressing the implants will also cause them to move intermuscularly with the additional side effect of misshaping the implants. Thus, compression is not desired for the disclosed dressing.
In addition, the Corrado dressing only applies minimal pressure to the upper surface of the breast. This in no way will provide the requisite compression needed to effectively prevent a hematoma or ecchymosis; it simply prevents intermuscular movement of the implants.
Thus, there still exists a need for a bandage that compresses a post-operative breast to effectively prevent hematoma or ecchymosis, and that is easy to apply, easily adjustable to fit, economical and comfortable. The present invention meets this need.